can cause major infection in immunocompromised patients and successful antibiotic treatment

Published May 31, 2016

can cause major infection in immunocompromised patients and successful antibiotic treatment of the infection relies on accurate and rapid identification of the infectious agents. implications in the early detection of infection. is an opportunistic pathogen that causes major infection not only in cystic fibrosis (CF) patients1 but also in chronic obstructive pulmonary disease (COPD) and in critically ill patients in intensive care units inducing ventilator associated infections2. It is a major nosocomial pathogen with significant morbidity and mortality (40-60%) in immunocompromised patients and in certain hospital units like burn and palliative care3. is the most common bacterial isolate that persists in the CF lung contributing to declining lung function1 4 Successful antibiotic treatment of the infection relies on accurate and rapid identification of the infectious agents. However the current diagnostic techniques based on bacterial culture usually take more than three days to obtain accurate results3. Therefore there is an urgent need to develop novel methods for rapid identification of the infecting agent. As a rapid and non-invasive optical technique Raman- and surface-enhanced Raman spectroscopy (SERS)-based techniques have been utilized in the identification of bacteria including infection were first reported by Rusciano spores9 10.11 The fluorescent pigments that previous researchers attempted to remove from the sample are confirmed as important biomarkers released by during its metabolism5 12 but these biomarkers has not been detected by SERS. Among these pigments pyocyanin (PCN) is a major virulence factor secreted by strains have been found to lose virulence14 15 PCN in clinical samples (e.g. sputa and isolates) has been extensively studied to understand its roles in infection among CF patients12 16 The concentration of PCN in the airways of CF patients was determined and found in a range between 0.9 and 16.5 ppm19 and secretion of PCN by clinical Labetalol HCl isolates of was also reported20. The presence and concentration of PCN in clinical specimens are traditionally determined through extraction of the pigment into chloroform or by high performance liquid chromatography (HPLC)21. But the time-consuming expensive and complex lab procedures have largely Labetalol HCl limited the use of HPLC as a diagnostic tool in clinical settings. To the best of our knowledge there is no report on the Raman or SERS detection of PCN as a biomarker to indicate infection in clinical samples. In this study we have successfully identified the SERS spectra of PCN both theoretically and experimentally and designed a strategy to rapidly detect the presence of in biofluid samples without the need to culture or isolate the bacteria. The detection can be completed Labetalol HCl within 1.5 h of sample receiving and in conjunction with chemometric analysis this non-invasive method is capable of detecting PCN from at as low as 5 ppb in the sputa of CF patients with 95.6% sensitivity and 93.3% specificity which could be employed to facilitate early diagnosis and treatment in CF infections. Methods Reagents and bacterial strains PCN was obtained from Cayman Chemicals (Ann Arbor MI). Luria-Bertani (LB) broth was obtained from Sigma Aldrich (St Louis MO). strain PAO1 which contains the pSMC21 plasmid constitutively expressing green fluorescent protein (GFP) was a kind gift from Dr. George O’Toole Dartmouth Medical School. strain PA14 was kindly donated by Dr. Joanna Goldberg Emory University School of Medicine. SERS substrate fabrication The bacterial SERS spectra were acquired using silver nanorod (AgNR) array substrates fabricated by the oblique angle deposition technique using a custom-designed electron beam evaporation (E-beam) system22-24. Briefly microscopic glass slides (BD Artn Portsmouth NH) were cleaned with piranha solution (80% sulfuric acid 20 hydrogen peroxide v/v) and rinsed with deionized (DI) water. The slides Labetalol HCl were then dried with a stream of nitrogen gas before being loaded Labetalol HCl into the E-beam system. A 20-nm titanium film and then a 200-nm silver film were first evaporated onto the glass slides at a rate of ~ 0.2 nm/s and 0.3 nm/s respectively monitored by a quartz crystal microbalance (QCM). The substrates were then tilted to 86° with respect to the incident vapor and AgNRs were grown at a deposition rate of ~ 0.3 nm/s until the QCM thickness reading reached 2000 nm. AgNR substrates have previously been shown to provide SERS enhancement factors of >108 a relative standard deviation (RSD) of 10% within the.